CareSource

 

Value-added benefits (VAB)

CareSource offers the below value-added benefits:

• Members aged 20 and younger receive a $100 allowance towards the purchase and fitting of contact lenses per year.
• Members aged 21 to 59 receive a $100 allowance towards the purchase and fitting of contact lenses every 2 years.

Refer to the EyeMed Ohio Medicaid Provider Manual (requires inFocus login to access) for full details.

 

Materials

Lenses

Medicaid considers standard lenses to be CR-39 plastic single vision with scratch-resistant coating or glass.

• Polycarbonate lenses are covered for all beneficiaries.
• Tints are covered only when medically necessary for conditions such as photophobia or albinism.
• Any other lens types and options are covered only when medically necessary.

Refer to the EyeMed Ohio Medicaid Provider Manual for full details. You must be logged into your account on inFocus to access the manual.

Contact lenses

You’ll file medically necessary contact lens claims on paper using the EyeMed Ohio Medicaid claim form. Prior authorization is required for medically necessary contact lenses.

Members qualify for medically necessary contact lens benefits for any of the below conditions:

• Aphakia
• Anisometropia
• Hyperopia
• Myopia
• Keratoconus
• Corneal Ectasia
• Other Corneal Deformities

 

Eyewear buy-ups

There are no buy-up options in the state of Ohio. If the Medicaid member wishes to purchase eyewear that exceeds their covered benefits, the member is responsible for paying out-of-pocket to cover the remaining costs.

 

Member ID cards 

Medicaid members will present CareSource ID cards like the one below.

Coming soon.

 

Related provider resources Provider Manual – Ohio Medicaid Registering for Medicaid network labs Filing claims for Medicaid Medically Necessary Contact Lens Form – Ohio Medicaid